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Job Details
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Requisition #:
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679386
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Location:
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Johns Hopkins Health Plans,
Hanover,
MD 21076
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Category:
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Healthcare Operations
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Schedule:
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Day Shift
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Employment Type:
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Full Time
The Credentialing Senior Business Analyst will provide primary analytical, reporting, and quality assurance support for the Credentialing Department, with a focus on ensuring accurate, reliable, and compliant reporting across operational, departmental, regulatory, and accreditation requirements. As a newly established role, the Credentialing Senior Business Analyst will focus primarily on Credentialing operations. As the function reaches steady state, the role will expand to include cross-training and support across other operational areas within the leader's scope. Department-Specific Responsibilities:
- Serve as the Credentialing Department's primary business analyst and reporting liaison, partnering with the Analytics Center of Excellence (ACOE), Business Intelligence (BI), Epic teams, internal stakeholders, and external vendor partners to develop, implement, validate, maintain, and continuously improve required Credentialing reporting and analytics.
- Lead the development and ongoing enhancement of Credentialing reporting and dashboards, including regulatory, accreditation, operational, departmental, quality assurance, and performance reporting, ensuring outputs are accurate, actionable, and aligned with business and compliance requirements.
- Develop and maintain a comprehensive understanding of Credentialing workflows, business processes, systems, data sources, and vendor processes to translate operational and regulatory needs into clear reporting requirements, data specifications, business rules, metrics, calculation methodologies, and validation criteria.
- Maintain working knowledge of applicable CMS, NCQA, DHA, MDH and other and other regulatory or accreditation reporting and audit requirements, and support organizational readiness by ensuring required reports, data elements, metrics, supporting documentation, and audit details are accurate, reproducible, and readily available.
- Perform quality assurance and validation of newly developed and existing reports, dashboards, data extracts, and metrics to ensure accuracy, completeness, consistency, and alignment with defined business requirements; investigate and resolve data integrity issues and discrepancies as needed.
- Partner with internal and external stakeholders to identify, reconcile, and appropriately integrate data from multiple systems and vendor sources when required to produce complete Credentialing reporting.
- Establish and maintain clear definitions, business rules, data sources, calculation methodologies, and validation processes for key Credentialing metrics to promote consistency and a single source of truth.
- Analyze Credentialing data to identify trends, performance opportunities, data integrity concerns, process gaps, and emerging compliance risks, translating findings into actionable insights and recommendations for departmental leadership.
- Partner with Credentialing leadership and operational teams to continuously evaluate reporting needs and identify opportunities to automate reporting, improve data quality, reduce manual processes, and strengthen departmental oversight and decision-making.
- Maintain comprehensive reporting and analytics documentation, including requirements, metric definitions, data sources, business rules, validation results, and change history to support operational continuity, audit readiness, and knowledge management.
- Serve as a subject matter resource for Credentialing data and reporting, supporting leadership and stakeholders in understanding report results, metric definitions, data limitations, and regulatory or accreditation reporting requirements.
Note: As a newly established position, the SBA will initially have a primary focus on Credentialing operations, supporting the continued development, stabilization, and optimization of the function. As Credentialing achieves a steady operational state, the role will expand to include cross-training and support across other operational areas within the leader's scope of responsibility, based on organizational and departmental needs. Key Skills and Responsibilities:
- Gather, analyze, and document business requirements for regulatory, operational, and management reporting.
- Extract, analyze, and reconcile data from Symplr and the Enterprise Data Warehouse (EDW).
- Develop and maintain reports, dashboards, and KPIs to monitor credentialing performance, compliance, and operational trends.
- Translate data into actionable business insights and recommendations for process improvement.
- Validate reporting deliverables for accuracy, completeness, and consistency before submission.
- Perform data quality audits of internal and vendor data, identify discrepancies, conduct root cause analysis, and recommend corrective actions.
- Serve as the liaison between Credentialing, ACOE/IT, Symplr, and other business stakeholders to support system enhancements and reporting needs.
- Track system and reporting issues, coordinate troubleshooting, validate fixes, and monitor issues through resolution.
- Identify opportunities to streamline workflows, automate manual reporting, and improve data integrity.
- Develop and maintain reporting documentation, including business requirements, data definitions, report specifications, and validation procedures.
Technical Skills and Systems Knowledge:
- Advanced Excel: Pivot tables, XLOOKUP, complex formulas, and data reconciliation.
- SQL: Working knowledge of querying, joining, filtering, and validating data.
- Power BI/Tableau: Dashboard development, data visualization, and KPI reporting.
- Symplr: Familiarity with credentialing data, workflows, and reporting capabilities.
- Enterprise Data Warehouse (EDW): Experience accessing, extracting, and analyzing enterprise data.
- Microsoft Office/SharePoint: Documentation, collaboration, and issue tracking.
Additional Competencies:
- Strong analytical, problem-solving, and root cause analysis skills.
- Excellent attention to detail and commitment to data accuracy.
- Ability to communicate technical findings clearly to nontechnical stakeholders.
- Ability to manage competing priorities and work independently.
- Healthcare experience, preferably in provider credentialing, regulatory reporting, or healthcare operations.
Qualifications:
- 3+ years of experience in a business analyst role within the healthcare field
- 5+ years of experience is preferred
- Experience with clinical healthcare data
- Business and/or data analyst experience in healthcare, specifically managed care
- Excellent communication skills, both verbal and written
- Bachelor's Degree in Business, Healthcare Management or related field preferred. Additional related work experience may substitute for some educational requirements.
Salary Range: Minimum 34.41/hour - Maximum 56.82/hour. Compensation will be commensurate with equity and experience for roles of similar scope and responsibility. In cases where the range is displayed as a $0 amount, salary discussions will occur during candidate screening calls, before any subsequent compensation discussion is held between the candidate and any hiring authority. The Hospital reserves the right to modify employee schedules as needed. We are committed to creating a welcoming and inclusive environment, where we embrace and celebrate our differences, where all employees feel valued, contribute to our mission of serving the community, and engage in equitable healthcare delivery and workforce practices. Johns Hopkins Health System and its affiliates are drug-free workplace employers. Johns Hopkins Health System and its affiliates are an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity and expression, age, national origin, mental or physical disability, genetic information, veteran status, or any other status protected by federal, state, or local law.
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